This paper discusses critically the hegemonic epistemology as applied to scientific medicine and its connections to some of the clinical dilemmas experienced by professionals and sick people, such as the difficulties in diagnostic fit and the doctor-patient relationship, fragmentation of diseases due to medical specialization, growing iatrogenesis, etc. It also makes the connection between this epistemology and the lack of a better and more harmonious relationship between scientific medicine and other forms of knowledge and practices in health. This hegemonic epistemology is characterized by a bio-mechanical, representational, positivist paradigm, based in diseases from the scientific lexicon. The article then introduces a new epistemological viewpoint with ideas from the theoretical convergence of contemporary authors from the natural sciences who form the front line in an innovative epistemological current still under formation called "co-constructional." Finally, the text outlines some of the possible developments in the application of this "co-construction" in health, indicating contributions and challenges proposes by this new epistemological perspective for the are of health and scientific research.
Epistemology; Metodology; Alternative medicine; Social medicine; Preventive medicine